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Vol 95, No 4 (2024)
Research paper
Published online: 2023-10-12
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Меtformin-associated maternal and neonatal outcomes in women with gestational diabetes — a retrospective cohort study

Vesselina Evtimova Yanachkova1, Radiana Staynova2, Svetoslav Stoev3, Zdravko Kamenov4
DOI: 10.5603/gpl.91632
·
Pubmed: 37842989
·
Ginekol Pol 2024;95(4):259-265.
Affiliations
  1. Department of Endocrinology, Specialized Hospital for Active Treatment of Obstetrics and Gynaecology “Dr Shterev”, Sofia, Bulgaria, Bulgaria
  2. Department of Pharmaceutical Sciences, Faculty of Pharmacy, Medical University of Plovdiv, Bulgaria
  3. Department of Pharmaceutical Sciences and Social Pharmacy, Faculty of Pharmacy, Medical University of Pleven, Bulgaria, Bulgaria
  4. Clinic of Endocrinology, Alexandrovska University Hospital, Medical University of Sofia, Bulgaria, Bulgaria

open access

Vol 95, No 4 (2024)
ORIGINAL PAPERS Obstetrics
Published online: 2023-10-12

Abstract

Objectives: To assess the maternal and neonatal outcomes in women with GDM treated with metformin, medical nutrition therapy (MNT) or insulin.

Material and methods: The current retrospective cohort study includes data from 233 women diagnosed with GDM who gave birth between January 2017 and January 2019 at an obstetrics and gynecology hospital in Sofia, Bulgaria. Patients were assigned to three groups, according to the treatment approach — metformin group (n = 70), insulin group (n = 40), and MNT group (n = 123). Values of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) have been evaluated at diagnosis of GDM and the third trimester of pregnancy. A comparative analysis of pregnancy outcomes and short-term neonatal characteristics in the investigated groups has been performed.

Results: Women indicated for pharmacological treatment (metformin or insulin) had significantly higher BMI (p < 0.01), FPG (p < 0.001), and HbA1c levels (p < 0.001) at baseline. However, during pregnancy, patients treated with metformin showed a significantly lower BMI (p < 0.01), FPG (p < 0.01), and HbA1c (p < 0.01). Neonates born to metformin-treated mothers had lower birth weight compared to those born to women in the MNT and insulin groups (metformin vs MNT, p < 0.001; metformin vs insulin, p = 0.03). The lowest incidence of newborns with macrosomia and neonatal hypoglycemia has been observed in the metformin cohort. Not a single newborn with an Apgar score under 7 has been identified in the metformin group.

Conclusions: According to the current analysis, women with GDM treated with metformin demonstrated better maternal and neonatal outcomes. No short-term complications in newborns have been associated with metformin use during pregnancy.

Abstract

Objectives: To assess the maternal and neonatal outcomes in women with GDM treated with metformin, medical nutrition therapy (MNT) or insulin.

Material and methods: The current retrospective cohort study includes data from 233 women diagnosed with GDM who gave birth between January 2017 and January 2019 at an obstetrics and gynecology hospital in Sofia, Bulgaria. Patients were assigned to three groups, according to the treatment approach — metformin group (n = 70), insulin group (n = 40), and MNT group (n = 123). Values of fasting plasma glucose (FPG) and glycated hemoglobin (HbA1c) have been evaluated at diagnosis of GDM and the third trimester of pregnancy. A comparative analysis of pregnancy outcomes and short-term neonatal characteristics in the investigated groups has been performed.

Results: Women indicated for pharmacological treatment (metformin or insulin) had significantly higher BMI (p < 0.01), FPG (p < 0.001), and HbA1c levels (p < 0.001) at baseline. However, during pregnancy, patients treated with metformin showed a significantly lower BMI (p < 0.01), FPG (p < 0.01), and HbA1c (p < 0.01). Neonates born to metformin-treated mothers had lower birth weight compared to those born to women in the MNT and insulin groups (metformin vs MNT, p < 0.001; metformin vs insulin, p = 0.03). The lowest incidence of newborns with macrosomia and neonatal hypoglycemia has been observed in the metformin cohort. Not a single newborn with an Apgar score under 7 has been identified in the metformin group.

Conclusions: According to the current analysis, women with GDM treated with metformin demonstrated better maternal and neonatal outcomes. No short-term complications in newborns have been associated with metformin use during pregnancy.

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Keywords

gestational diabetes; metformin; insulin; maternal outcomes; neonatal outcomes

About this article
Title

Меtformin-associated maternal and neonatal outcomes in women with gestational diabetes — a retrospective cohort study

Journal

Ginekologia Polska

Issue

Vol 95, No 4 (2024)

Article type

Research paper

Pages

259-265

Published online

2023-10-12

Page views

380

Article views/downloads

811

DOI

10.5603/gpl.91632

Pubmed

37842989

Bibliographic record

Ginekol Pol 2024;95(4):259-265.

Keywords

gestational diabetes
metformin
insulin
maternal outcomes
neonatal outcomes

Authors

Vesselina Evtimova Yanachkova
Radiana Staynova
Svetoslav Stoev
Zdravko Kamenov

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